What is chronic fatigue?
Chronic fatigue is persistent exhaustion lasting weeks to months that isn't fully relieved by rest. It's a common reason people seek care.
Causes include thyroid disease, anemia, depression, sleep disorders, vitamin deficiencies, medications, autoimmune conditions, ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome). A systematic workup usually identifies treatable causes.
Do I have chronic fatigue? Common signs
If most of these describe what you're experiencing, telehealth may be a good next step:
What causes it
Many: depression, anxiety, hypothyroidism, anemia (iron deficiency), vitamin D deficiency, sleep apnea, insomnia, mononucleosis or post-viral, ME/CFS, fibromyalgia, autoimmune diseases (lupus, RA), medications, alcohol, untreated chronic conditions.
Is it contagious?
Depends on underlying cause.
Iron deficiency drives a lot of unexplained fatigue — especially in menstruating women — and ferritin is often normal-looking but low for symptom relief.
Can it be treated online?
Chronic fatigue evaluation is well-suited to telehealth. Severe progressive fatigue with weight loss, unexplained fevers, neurologic symptoms — need in-person workup. ME/CFS specifically benefits from specialty evaluation.
How chronic fatigue is treated
Treat identified causes. Iron deficiency: iron supplementation, target ferritin >75. Hypothyroidism: levothyroxine. Vitamin D: supplementation. Sleep apnea: CPAP. Depression: SSRIs, therapy. Insomnia: CBT-I and treatment. ME/CFS: pacing, supportive care; no specific cure but management strategies help.
Self-care while you wait
- Consistent sleep schedule
- Regular gentle exercise (pacing — don't overdo)
- Address sleep apnea if signs
- Optimize diet — adequate protein and iron
- Manage stress
- Limit alcohol — disrupts sleep
- Check vitamin D, B12, iron
- Treat underlying mood issues
- Pacing energy — avoid push-crash cycles
How long does it last?
With treatable causes addressed, weeks to months. Chronic conditions need ongoing management.
Frequently asked questions
What labs should I get?
Standard workup: CBC, ferritin, TSH, vitamin D, B12, basic metabolic panel. Targeted additional testing based on history.
Is it adrenal fatigue?
'Adrenal fatigue' isn't a recognized medical diagnosis. Adrenal insufficiency (Addison's) is a real but uncommon condition with specific lab findings.
How do I know if it's depression?
Depression often has low mood, loss of interest, sleep changes. Fatigue alone without these is less likely depression. Often coexists.
What is ME/CFS?
Distinct condition with profound fatigue plus post-exertional malaise, sleep issues, cognitive problems. Diagnosed by clinical criteria. No specific test.
Will exercise help or hurt?
For most fatigue, gentle gradual exercise helps. For ME/CFS, overexertion can severely worsen — pacing is key.
